The measles outbreak linked to two California Disney theme parks (Disneyland and Disney California Adventure) continues it’s spread, now affecting at least seven states and Mexico. An eighth state, Michigan, has reported their first case of the year and “may be associated with the recent Disneyland outbreak in California, but an exact connection has not yet been determined”.

Measles rashImage/CDC

As of Friday, the California Department of Public Health (CDPH) reports 68 confirmed measles cases with 48 epidemiologically linked to the Disney theme parks. Other states affected by the outbreak include Utah (3), Washington (2), Colorado, Oregon, Nebraska and Arizona with one case each. Mexico has also reported a case linked to the parks.

The outbreak prompted the Centers for Disease Control and Prevention (CDC) to issue a health advisory Friday. CDC says at this time, no source case for the outbreak has been identified, but it is likely that a traveler (or more than one traveler) who was infected with measles overseas visited one or both of the Disney parks in December during their infectious period.

Health officials say 86 percent of those affected were unvaccinated or had an unknown vaccination status. Six were vaccinated against measles (2 had received 1 dose and 4 had received 2 or more doses).

This has caused several organization to urge parents to vaccinate their children. The CDC says health care providers need to ensure all patients are up to date on Measles-Mumps and Rubella (MMR) vaccine and other vaccines.

The American Academy of Pediatrics (AAP) and its 62,000 member pediatricians urges parents, schools and communities to commit to protecting our nation’s infants, children, adolescents and adults with the most effective tool we have – vaccination.

“A family vacation to an amusement park – or a trip to the grocery store, a football game or school – should not result in children becoming sickened by an almost 100 percent preventable disease,” said AAP Executive Director/CEO Errol R. Alden, MD, FAAP. “We are fortunate to have an incredibly effective tool that can prevent our children from suffering. That is so rare in medicine.

“Vaccines are one of the most important ways parents can protect their children from very real diseases that exist in our world,” Dr. Alden said. “The measles vaccine is safe and effective. The AAP urges parents to have their children immunized against measles, as well as other infectious diseases, and to talk with their child’s pediatrician if they have questions about any of their child’s recommended vaccines.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Friday on CBS This Morning, “It really is a shame that children are not allowed to get vaccinated by their parents.”

Concerning the virus itself, the CDC reports the measles genotype information was available from 9 measles cases; all were genotype B3 and all sequences linked to this outbreak are identical. The sequences are also identical to the genotype B3 virus that caused a large outbreak in the Philippines in 2014. During the last 6 months, identical genotype B3 viruses were also detected in at least 14 countries and at least 6 U.S. states, not including those linked to the current outbreak.

Measles is a highly contagious, acute viral illness. It begins with a prodrome of fever, cough, coryza (runny nose), conjunctivitis (pink eye), lasting 2-4 days prior to rash onset. Measles can cause severe health complications, including pneumonia, encephalitis, and death. Measles is transmitted by contact with an infected person through coughing and sneezing; infected people are contagious from 4 days before their rash starts through 4 days afterwards. After an infected person leaves a location, the virus remains viable for up to 2 hours on surfaces and in the air.

The United States experienced a record number of measles cases during 2014, with 644 cases from 27 states reported to CDC’s National Center for Immunization and Respiratory Diseases (NCIRD). This is the greatest number of cases since measles elimination was documented in the U.S. in 2000.